Jacob is a junior in high school who started seeing Dr. Alvarez, the psychologist at his school, during his freshman year. All through elementary and middle school, Jacob loved playing football and was a good student. Shortly into his freshman year, however, he abruptly quit the football team, and his grades started to slide. His parents and teachers were concerned about his mood and declining grades and asked him to start seeing Dr. Alvarez.

During their first meeting, Jacob explained that he feels sad almost every day and that he quit the football team because he felt that he didn’t deserve to be on the team. This pessimism extended to many aspects of Jacob’s life. Whenever something positive happened, he had difficulty accepting it because he viewed himself as “a bad person.” He said that although he had never thought about killing himself, he just feels “kind of down all the time,” has trouble concentrating at school, and has difficulty falling asleep. He said that he used to like school but doesn’t really care about it now. He claims that he comes to school because it’s easier than finding something else to do. Dr. Alvarez asked him to start rating his mood each day, and Jacob has done this ever since. He rates his mood as lower than normal.

During his first two years of high school, Jacob put little effort into making friends and mostly withdrew socially. In fact, his initial attempts at making friends seemed to provide certain students with an excuse to ridicule him. The more they made fun of Jacob, the more he withdrew, which made him an even easier target. Providing Jacob with social skills and assertiveness training has alleviated this to some extent, and he maintains a small, though tight-knit, circle of friends.

To date, Jacob has not displayed any combative behavior, and he continues to attend school regularly, despite his lethargy and apathy. Testing shows that Jacob does not have a psychotic disorder, and he has never displayed evidence of a medical disorder or substance abuse.

QUESTION 4

Potential diagnosis

Based on the full diagnostic criteria listed by the DSM-5 for mood disorders (not just the symptoms highlighted in the previous question), Jacob appears to meet the criteria for a diagnosis of

1. Major Depressive Disorder
2. Persistent Depressive Disorder
3. Chronic Major Depressive Disorder

Jacob is a junior in high school who started seeing Dr. Alvarez, the psychologist at his school, during his freshman year. All through elementary and middle school, Jacob loved playing football and was a good student. Shortly into his freshman year, however, he abruptly quit the football team, and his grades started to slide. His parents and teachers were concerned about his mood and declining grades and asked him to start seeing Dr. Alvarez.

During their first meeting, Jacob explained that he feels sad almost every day and that he quit the football team because he felt that he didn’t deserve to be on the team. This pessimism extended to many aspects of Jacob’s life. Whenever something positive happened, he had difficulty accepting it because he viewed himself as “a bad person.” He said that although he had never thought about killing himself, he just feels “kind of down all the time,” has trouble concentrating at school, and has difficulty falling asleep. He said that he used to like school but doesn’t really care about it now. He claims that he comes to school because it’s easier than finding something else to do. Dr. Alvarez asked him to start rating his mood each day, and Jacob has done this ever since. He rates his mood as lower than normal.

During his first two years of high school, Jacob put little effort into making friends and mostly withdrew socially. In fact, his initial attempts at making friends seemed to provide certain students with an excuse to ridicule him. The more they made fun of Jacob, the more he withdrew, which made him an even easier target. Providing Jacob with social skills and assertiveness training has alleviated this to some extent, and he maintains a small, though tight-knit, circle of friends.

To date, Jacob has not displayed any combative behavior, and he continues to attend school regularly, despite his lethargy and apathy. Testing shows that Jacob does not have a psychotic disorder, and he has never displayed evidence of a medical disorder or substance abuse.

Question Many forms of treatment attempt to address the cognitive factors that contribute to mood disorders. In Jacob’s case, what might a therapist’s goal be, in regard to his cognitive style?

1. To get Jacob to view himself more positively
2. To get Jacob to stop thinking about suicide
3. To get Jacob to have a more docile personality

Jacob is a junior in high school who started seeing Dr. Alvarez, the psychologist at his school, during his freshman year. All through elementary and middle school, Jacob loved playing football and was a good student. Shortly into his freshman year, however, he abruptly quit the football team, and his grades started to slide. His parents and teachers were concerned about his mood and declining grades and asked him to start seeing Dr. Alvarez.

During their first meeting, Jacob explained that he feels sad almost every day and that he quit the football team because he felt that he didn’t deserve to be on the team. This pessimism extended to many aspects of Jacob’s life. Whenever something positive happened, he had difficulty accepting it because he viewed himself as “a bad person.” He said that although he had never thought about killing himself, he just feels “kind of down all the time,” has trouble concentrating at school, and has difficulty falling asleep. He said that he used to like school but doesn’t really care about it now. He claims that he comes to school because it’s easier than finding something else to do. Dr. Alvarez asked him to start rating his mood each day, and Jacob has done this ever since. He rates his mood as lower than normal.

During his first two years of high school, Jacob put little effort into making friends and mostly withdrew socially. In fact, his initial attempts at making friends seemed to provide certain students with an excuse to ridicule him. The more they made fun of Jacob, the more he withdrew, which made him an even easier target. Providing Jacob with social skills and assertiveness training has alleviated this to some extent, and he maintains a small, though tight-knit, circle of friends.

To date, Jacob has not displayed any combative behavior, and he continues to attend school regularly, despite his lethargy and apathy. Testing shows that Jacob does not have a psychotic disorder, and he has never displayed evidence of a medical disorder or substance abuse.

QUESTION 1

1. One important consideration in determining whether someone has a mood disorder is the extent to which his or her life is disrupted. Jacob’s condition has produced several kinds of functional disruptions. What aspect of Jacob’s personal function is affected by his condition?
2. He has pushed most of his friends away and feels very lonely.
3. He no longer communicates with his parents and tries to avoid them.
4. He has lost interest in activities that were previously pleasurable.

QUESTION 2

1. Many forms of treatment attempt to address the cognitive factors that contribute to mood disorders. In Jacob’s case, what might a therapist’s goal be, in regard to his cognitive style?
2. To get Jacob to view himself more positively
3. To get Jacob to stop thinking about suicide
4. To get Jacob to have a more docile personality

QUESTION 3

1. Diagnostic criteria checklist
2. Some of the symptoms associated with various mood disorders are listed below. Indicate which symptoms are clearly present in Jacob’s case. Check all that apply. Note you can select multiple answers.
3. Psychomotor agitation or sense of slowness
4. No presence of mania or hypomania
5. Has not gone longer than two months without depressive symptoms
6. Depressive symptoms for at least two years
7. Excessively talkative

QUESTION 4

Potential diagnosis

Based on the full diagnostic criteria listed by the DSM-5 for mood disorders (not just the symptoms highlighted in the previous question), Jacob appears to meet the criteria for a diagnosis of

1. Major Depressive Disorder
2. Persistent Depressive Disorder
3. Chronic Major Depressive Disorder